Pemberian Keutamaan & Delegasi Gaya NCLEX: pek ulang kaji kilat

Pesakit manakah yang patut dilihat dahulu oleh jururawat?

1. APesakit dengan pertuturan pelat baharu dan muka terkulai yang bermula 30 minit lalu
2. BPesakit diabetes jenis 2 yang bertanya tentang diet
3. CPesakit penyakit buah pinggang kronik yang dijadualkan dialisis esok
4. DPesakit dengan artritis reumatoid yang sudah lama dan kekakuan sendi pagi yang biasa

Seorang jururawat menganggap dos yang ditetapkan tidak selamat. Pemreskripsi menyuruh memberikannya juga. Apakah yang patut dilakukan oleh jururawat?

1. ATahan dos dan eskalasi melalui rantaian pemerintahan
2. BBeri separuh dos sebagai kompromi dan dokumenkan sebabnya
3. CBeri dos itu, kerana pemreskripsi kini bertanggungjawab atasnya
4. DLangkau dos secara senyap dan tidak berkata apa-apa untuk mengelakkan konflik

How should a nurse handle soiled bed linen?

1. APut it on the floor until the bed is made
2. BShake it out first to check for lost items
3. CHold it away from the uniform and place it straight into a linen bag
4. DCarry it bundled against the body to the soiled utility room down the hall

A patient on a general ward for two days is found to have smear-positive pulmonary TB. What should the nurse do besides moving the patient to an airborne isolation room?

1. ANothing more, because the patient has now been isolated
2. BInform infection prevention so exposed patients and staff can be identified and followed up
3. CClose the ward to all new admissions for a full year
4. DTell all the exposed patients to start TB drugs at once, before any testing

A healthy patient's result is slightly outside the laboratory reference range, and all other results are normal. Which statement best explains why this can happen?

1. ARanges cover about 95% of healthy people, so some fall outside
2. BReference ranges are the same in every laboratory worldwide
3. CReference ranges include every healthy person without exception
4. DAny result outside the range always means disease is present

After lying on the floor for many hours, a patient has a CK of 40,000 U/L, a potassium of 6.1 mEq/L and dark urine. Which prescribed treatment is the priority?

1. AHigh-dose NSAIDs for the muscle pain
2. BLarge-volume IV fluids with cardiac monitoring
3. CAn oral potassium supplement with each meal
4. DFluid restriction to protect the heart from overload

Which equipment must always be kept at the bedside of a patient with a tracheostomy?

1. AA peak flow meter and a nebuliser
2. BSpare tracheostomy tubes, including one a size smaller, and working suction
3. CA blood glucose meter and a spare urinary catheter of the same size
4. DA blood pressure cuff and a spare nasal cannula and oxygen mask only

Why can pulse oximetry be misleading in carbon monoxide poisoning?

1. AStandard oximeters cannot tell carboxyhaemoglobin from oxyhaemoglobin
2. BThe oximeter overheats in smoke-exposed patients
3. CCarbon monoxide makes the oximeter read zero even in a well patient
4. DCarbon monoxide only affects the heart rate reading

A patient has a heart rate of 36/min with hypotension and dizziness. Which drug is usually the first choice?

1. AIntravenous atropine
2. BIntravenous adenosine
3. CIntravenous amiodarone
4. DOral bisoprolol

A nurse looked after a patient for a shift before smear-positive pulmonary TB was diagnosed, without wearing a respirator. What should happen?

1. AStay off work for six months in case symptoms develop
2. BReport it so occupational health can arrange follow-up screening
3. CTake no action, as healthcare workers are immune to TB
4. DStart a full six-month course of TB drugs at once without any tests

A patient has taken metformin for many years and now has tingling feet and a low haemoglobin. Which blood test is most relevant?

1. AVitamin B12 level
2. BBlood alcohol level
3. CThyroid antibodies
4. DSerum amylase

The nurse has four patients with diabetes. Which one needs to be seen first?

1. AA patient waiting for a routine HbA1c test
2. BA patient with a glucose of 14 mmol/L (252 mg/dL) who feels well and is eating
3. CA patient with a glucose of 2.8 mmol/L (50 mg/dL) who is sweaty and confused
4. DA newly diagnosed patient asking about which foods to eat

A day after a spinal anaesthetic, a patient has a headache that is worse when sitting up and better when lying flat. What is the most likely cause?

1. AMigraine caused by hospital lighting
2. BPost-dural puncture headache
3. CA side effect of the antibiotic
4. DRaised blood pressure from pain

A patient took a large paracetamol (acetaminophen) overdose 6 hours ago and says they feel completely well. Which statement is correct?

1. AFeeling well means the dose was too small to cause harm
2. BTreatment is not needed if the patient has not vomited
3. CLiver damage after paracetamol occurs only within the first hour or so
4. DLiver damage may still develop, and appears only days later